Provider Demographics
NPI:1770685026
Name:VELEZ-FELICIANO, JESUS (MD)
Entity Type:Individual
Prefix:DR
First Name:JESUS
Middle Name:
Last Name:VELEZ-FELICIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 1 A 19
Mailing Address - Street 2:VILLAS DE LEVITTON
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4902
Mailing Address - Country:US
Mailing Address - Phone:787-261-4589
Mailing Address - Fax:787-261-4589
Practice Address - Street 1:112 CALLE ARZUAGA
Practice Address - Street 2:CONDOMINIO MEDINA CENTER OF 606
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3321
Practice Address - Country:US
Practice Address - Phone:787-764-8296
Practice Address - Fax:787-764-8296
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7539207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0088065Medicare ID - Type Unspecified
PRG44108Medicare UPIN